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90_SB0948
New Act
Creates the Death with Dignity Act. Establishes
procedures by which a terminally ill patient may request
cessation of hydration and all medical procedures to prolong
life in order to enable the patient to end his or her life in
a dignified and humane manner. Imposes duties on the
patient's attending physician. Provides for immunity from
civil and criminal liability and professional disciplinary
action for acting in good faith compliance with the Act.
Makes it a Class 1 felony (i) to alter or forge a patient's
request under the Act or to conceal or destroy a patient's
rescission of a request or (ii) to coerce or exert undue
influence on a patient to make or destroy a request.
Requires the Department of Human Services to collect certain
information.
LRB9002618DJcd
LRB9002618DJcd
1 AN ACT to provide for death with dignity.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 1. Short title. This Act may be cited as the
5 Death with Dignity Act.
6 Section 5. Definitions. In this Act, unless the context
7 requires otherwise:
8 "Adult" means a person who is (i) 18 years of age or
9 older or (ii) an emancipated minor under the Emancipation of
10 Mature Minors Act.
11 "Attending physician" means the physician licensed to
12 practice medicine in all its branches who has primary
13 responsibility for the care of the patient and treatment of
14 the patient's terminal disease.
15 "Consulting physician" means a physician licensed to
16 practice medicine in all its branches who is qualified by
17 specialty or experience to make a professional diagnosis and
18 prognosis regarding the patient's disease.
19 "Counseling" means a consultation between a psychiatrist
20 or psychologist licensed to practice in this State and a
21 patient for the purpose of determining whether the patient is
22 suffering from depression causing impaired judgment or from a
23 psychiatric or psychological disorder.
24 "Health care facility" means a type of health care
25 provider commonly known by a wide variety of titles,
26 including, but not limited to, hospitals, medical centers,
27 nursing homes, rehabilitation centers, long-term or tertiary
28 care facilities, and other facilities established to
29 administer health care and provide overnight stays in their
30 ordinary course of business or practice.
31 "Health care provider" means a person that is licensed,
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1 certified, or otherwise authorized or permitted by the law of
2 this State to administer health care in the ordinary course
3 of business or practice of a profession. The term includes a
4 health care facility.
5 "Incapable" means that in the opinion of a court or in
6 the opinion of the patient's attending physician or
7 consulting physician, a patient lacks the ability to make and
8 communicate health care decisions to health care providers,
9 including communication through persons familiar with the
10 patient's manner of communicating if those persons are
11 available. "Capable" means not incapable.
12 "Informed decision" means a decision that is (i) made by
13 a qualified patient to request and obtain cessation of
14 hydration and all medical procedures to prolong life as a
15 means to end his or her life in a humane and dignified
16 manner, (ii) based on the patient's appreciation of the
17 relevant facts, and (iii) made after the patient is fully
18 informed of all of the following by the attending physician:
19 (1) The patient's medical diagnosis.
20 (2) The patient's prognosis.
21 (3) The probable result of ceasing hydration and
22 all medical procedures to prolong life.
23 (4) The feasible alternatives to ceasing hydration
24 and all medical procedures to prolong life, including but
25 not limited to comfort care, hospice care, and pain
26 control.
27 "Medically confirmed" means that the medical opinion of
28 the attending physician has been confirmed by a consulting
29 physician who has examined the patient and the patient's
30 relevant medical records.
31 "Patient" means a person who is under the care of a
32 physician licensed to practice medicine in all its branches.
33 "Qualified patient" means a capable adult who is a
34 resident of Illinois and who has satisfied the requirements
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1 of this Act in order to obtain cessation of hydration and all
2 medical procedures to prolong life as a means to end his or
3 her life in a humane and dignified manner.
4 "Request under this Act" or "request" means a person's
5 request for cessation of hydration and all medical procedures
6 to prolong life as a means to end his or her life in a humane
7 and dignified manner, as authorized under Section 10.
8 "Terminal disease" means an incurable and irreversible
9 disease that has been medically confirmed and that will,
10 within reasonable medical judgment, produce death within 6
11 months.
12 Section 10. Person who may make request. An adult who
13 is capable, who is a resident of Illinois, who has been
14 determined by the attending physician and consulting
15 physician to be suffering from a terminal disease, and who
16 has voluntarily expressed his or her wish to die may make a
17 written request for cessation of hydration and all medical
18 procedures to prolong his or her life for the purpose of
19 ending his or her life in a humane and dignified manner in
20 accordance with this Act.
21 Section 15. Form of request.
22 (a) A valid request under this Act shall be in
23 substantially the form set forth in this Section, shall be
24 signed and dated by the patient, and shall be witnessed by at
25 least 2 individuals who, in the presence of the patient,
26 attest that to the best of their knowledge and belief the
27 patient is capable, is acting voluntarily in making the
28 request, and is not being coerced to sign the request.
29 (b) One of the witnesses shall be a person who is not
30 any of the following:
31 (1) A relative of the patient by blood, marriage,
32 or adoption.
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1 (2) A person who at the time the request is signed
2 would be entitled to any portion of the patient's estate
3 upon the patient's death under any will or by operation
4 of law.
5 (3) An owner, operator, or employee of a health
6 care facility where the patient is receiving medical
7 treatment or is a resident.
8 (c) The patient's attending physician at the time the
9 request is signed shall not be a witness.
10 (d) If the patient is an inpatient at a health care
11 facility at the time the written request is made, one of the
12 witnesses shall be an individual designated by the facility
13 and having the qualifications specified by the Department of
14 Public Health by rule.
15 (e) A request for cessation of hydration and all medical
16 procedures to prolong life shall be in substantially the
17 following form:
18 REQUEST FOR ACTION TO END MY
19 LIFE IN A HUMANE AND DIGNIFIED MANNER
20 I, .........., am an adult of sound mind.
21 I am suffering from .........., which my attending
22 physician has determined is a terminal disease and which has
23 been medically confirmed by a consulting physician.
24 I have been fully informed of my diagnosis and prognosis,
25 the nature of the action to be taken to cease hydration and
26 all medical procedures to prolong my life, the expected
27 result, and the feasible alternatives, including comfort
28 care, hospice care, and pain control.
29 I request that my attending physician cease hydration and
30 all medical procedures to prolong my life as a means to end
31 my life in a humane and dignified manner.
32 INITIAL ONE:
33 ..... I have informed my family of my decision and taken
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1 their opinions into consideration.
2 ..... I have decided not to inform my family of my decision.
3 ..... I have no family to inform of my decision.
4 I understand that I have the right to rescind this
5 request at any time.
6 I understand the full import of this request and I expect
7 to die after cessation of hydration and all medical
8 procedures to prolong my life.
9 I make this request voluntarily and without reservation,
10 and I accept full moral responsibility for my actions.
11 Signed: .................... Dated: ....................
12 DECLARATION OF WITNESSES
13 We declare that the person signing this request:
14 (1) is personally known to us or has provided proof of
15 identity;
16 (2) signed this request in our presence;
17 (3) appears to be of sound mind and not under duress,
18 fraud, or undue influence; and
19 (4) is not a patient for whom either of us serves as a
20 physician.
21 .................... Witness 1 Date ....................
22 .................... Witness 2 Date ....................
23 NOTE: One witness shall be an individual who is not a
24 relative (by blood, marriage, or adoption) of the person
25 signing this request, is not entitled to any portion of the
26 person's estate upon death, and does not own or operate and
27 is not employed at a health care facility where the person is
28 a patient or resident. If the patient is an inpatient at a
29 health care facility, one of the witnesses shall be an
30 individual designated by the facility.
31 Section 20. Attending physician responsibilities. The
32 attending physician shall do all of the following:
33 (1) Make the initial determination of whether a
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1 patient has a terminal disease, is capable, and has made
2 the request under this Act voluntarily.
3 (2) Inform the patient of all of the following:
4 (A) The patient's medical diagnosis.
5 (B) The patient's prognosis.
6 (C) The probable result of ceasing hydration
7 and all medical products to prolong the patient's
8 life.
9 (D) The feasible alternatives to ceasing
10 hydration and all medical procedures to prolong the
11 patient's life, including but not limited to comfort
12 care, hospice care, and pain control.
13 (3) Refer the patient to a consulting physician for
14 medical confirmation of the diagnosis and for a
15 determination that the patient is capable and acting
16 voluntarily in making a request under this Act.
17 (4) Refer the patient for counseling, if
18 appropriate, pursuant to Section 30.
19 (5) Request that the patient notify his or her next
20 of kin.
21 (6) Inform the patient that he or she has an
22 opportunity to rescind the request under this Act at any
23 time and in any manner.
24 (7) Verify that the patient is making an informed
25 decision.
26 (8) Fulfill the medical record documentation
27 requirements of Section 60.
28 (9) Ensure that all appropriate steps are carried
29 out in accordance with this Act before authorizing the
30 cessation of hydration and all medical procedures to
31 prolong the patient's life in order to enable the patient
32 to end his or her life in a humane and dignified manner.
33 Section 25. Consulting physician confirmation. Before a
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1 patient is considered qualified under this Act, a consulting
2 physician shall examine the patient and his or her relevant
3 medical records and (i) confirm, in writing, the attending
4 physician's diagnosis that the patient is suffering from a
5 terminal disease and (ii) verify that the patient is capable,
6 is acting voluntarily in making a request under this Act, and
7 has made an informed decision in making that request.
8 Section 30. Counseling referral. If in the opinion of
9 the attending physician or the consulting physician a patient
10 may be suffering from depression causing impaired judgment or
11 from a psychiatric or psychological disorder, either
12 physician shall refer the patient for counseling. No action
13 to cease hydration and all medical procedures to prolong life
14 as a means to end a patient's life in a humane and dignified
15 manner shall be taken until the person performing the
16 counseling determines that the patient is not suffering from
17 depression causing impaired judgment or from a psychiatric or
18 psychological disorder.
19 Section 35. Illinois residence required. A person's
20 request under this Act shall not be granted unless the person
21 is a resident of Illinois.
22 Section 40. Informed decision required. A person's
23 request under this Act shall not be granted unless the person
24 has made an informed decision as defined in Section 5.
25 Immediately before taking action to cease hydration and all
26 medical procedures to prolong life as a means to end a
27 patient's life in a humane and dignified manner under this
28 Act, the attending physician shall verify that the patient is
29 making an informed decision.
30 Section 45. Family notification. The attending
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1 physician shall ask the patient to notify the patient's next
2 of kin of his or her request under this Act. A patient who
3 declines or is unable to notify his or her next of kin shall
4 not have his or her request denied for that reason.
5 Section 50. Written and oral requests. In order for a
6 qualified patient's request under this Act to be granted, the
7 patient shall have made an oral request and a written request
8 and shall have repeated the oral request to his or her
9 attending physician. At the time the qualified patient makes
10 his or her second oral request, the attending physician shall
11 offer the patient an opportunity to rescind the request.
12 Section 55. Right to rescind request. A patient may
13 rescind his or her request under this Act at any time and in
14 any manner without regard to his or her mental state. No
15 action to cease hydration and all medical procedures to
16 prolong life in order to enable the patient to end his or her
17 life in a humane and dignified manner may be taken without
18 the attending physician offering the patient an opportunity
19 to rescind the request.
20 Section 60. Medical record documentation requirements.
21 The following shall be documented or filed in the patient's
22 medical record:
23 (1) All oral requests under this Act made by a
24 patient.
25 (2) All written requests under this Act made by a
26 patient.
27 (3) The attending physician's diagnosis and
28 prognosis and determination that the patient is capable
29 and acting voluntarily in making a request under this Act
30 and has made an informed decision in making that request.
31 (4) The consulting physician's diagnosis and
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1 prognosis and verification that the patient is capable
2 and acting voluntarily in making a request under this Act
3 and has made an informed decision in making that request.
4 (5) A report of the outcome and determinations made
5 during counseling, if performed.
6 (6) The attending physician's offer of an
7 opportunity to the patient to rescind his or her request
8 at the time of the patient's second oral request pursuant
9 to Section 50.
10 (7) A note by the attending physician indicating
11 that all requirements under this Act have been met and
12 indicating the steps taken to carry out the patient's
13 request.
14 Section 65. Department of Human Services review of
15 records; statistical report. The Department of Human
16 Services, in its capacity as the successor agency to the
17 Department of Mental Health and Developmental Disabilities,
18 shall do the following:
19 (1) Annually review a sample of the records
20 maintained under this Act.
21 (2) Adopt rules to facilitate the collection of
22 information regarding compliance with this Act. The
23 information collected shall not be a public record and
24 may not be made available for inspection by the public.
25 (3) Generate and make available to the public an
26 annual statistical report summarizing the information
27 collected under paragraph (2). The report shall not
28 contain any information that either directly or
29 indirectly identifies individual patients.
30 Section 70. Immunities. Except as provided in this Act:
31 (1) A person is not subject to civil or criminal
32 liability or professional disciplinary action for acting
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1 in good faith compliance with this Act. This includes
2 being present when hydration and all medical procedures
3 to prolong life are ceased in response to a qualified
4 patient's request under this Act.
5 (3) A request under this Act by a patient or action
6 taken by an attending physician to cease hydration and
7 all medical procedures to prolong life in good faith
8 compliance with the provisions of this Act does not
9 constitute neglect for any purpose of law or provide the
10 sole basis for the appointment of a guardian or
11 conservator.
12 (4) A health care provider is not under any duty,
13 whether by contract, by statute, or by any other legal
14 requirement, to participate in the cessation of hydration
15 and all medical procedures to prolong a qualified
16 patient's life in order to enable the patient to end his
17 or her life in a humane and dignified manner as provided
18 in this Act. If a health care provider is unable or
19 unwilling to carry out a qualified patient's request
20 under this Act and the patient transfers his or her care
21 to a new health care provider, the prior health care
22 provider shall transfer, upon request, a copy of the
23 patient's relevant medical records to the new health care
24 provider.
25 Section 75. Penalties and other liability.
26 (a) A person who without authorization of the patient
27 willfully alters or forges the patient's request under this
28 Act or conceals or destroys a rescission of that request with
29 the intent or effect of causing the patient's death is guilty
30 of a Class 1 felony.
31 (b) A person who coerces or exerts undue influence on a
32 patient to make a request under this Act for the purpose of
33 ending the patient's life or to destroy a rescission of such
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1 a request is guilty of a Class 1 felony.
2 (c) Nothing in this Act limits further liability for
3 civil damages resulting from other negligent conduct or
4 intentional misconduct by any person.
5 (d) The penalties in this Act do not preclude criminal
6 penalties applicable under other laws for conduct that is
7 inconsistent with this Act.
8 Section 80. Effect on construction of wills and
9 contracts.
10 (a) A provision in a contract, will, or other agreement,
11 whether written or oral, is not valid to the extent that the
12 provision would affect whether a person may make or rescind a
13 request under this Act.
14 (b) An obligation owing under any currently existing
15 contract may not be conditioned or affected by the making or
16 rescinding of a request by a person under this Act.
17 Section 85. Insurance or annuity policies. The sale,
18 procurement, or issuance of any life or accident and health
19 insurance policy or annuity policy or the rate charged for
20 any policy may not be conditioned on or affected by the
21 making or rescinding of a request by a person under this Act.
22 Action taken to cease hydration and all medical procedures to
23 prolong life in response to a qualified patient's request
24 under this Act in order to enable the patient to end his or
25 her life in a humane and dignified manner shall not have an
26 effect upon a life or accident and health insurance policy or
27 annuity policy.
28 Section 90. Construction of Act. Nothing in this Act
29 shall be construed to authorize a physician or any other
30 person to end a patient's life by lethal injection, mercy
31 killing, or active euthanasia. Actions taken in accordance
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1 with this Act do not, for any purpose, constitute suicide,
2 mercy killing, or homicide under the law.
3 Section 95. Severability. The provisions of this Act
4 are severable under Section 1.31 of the Statute on Statutes.
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